Provider Demographics
NPI:1548648454
Name:RUTH ELLIOTT LICSW
Entity type:Organization
Organization Name:RUTH ELLIOTT LICSW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:
Authorized Official - Last Name:ELLIOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-556-2897
Mailing Address - Street 1:88 E HUNTRESS POND RD
Mailing Address - Street 2:
Mailing Address - City:CENTER BARNSTEAD
Mailing Address - State:NH
Mailing Address - Zip Code:03225-3718
Mailing Address - Country:US
Mailing Address - Phone:603-556-2897
Mailing Address - Fax:886-582-5384
Practice Address - Street 1:200 N STATE ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-3222
Practice Address - Country:US
Practice Address - Phone:603-556-2897
Practice Address - Fax:886-582-5384
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-12
Last Update Date:2015-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH11921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty